Research Review: Psychological and psychosocial interventions for children and adolescents with depression, anxiety, and post-traumatic stress disorder in low- and middle-income countries - a systematic review and meta-analysis

BackgroundThe incidence of depression, anxiety, and post-traumatic stress disorder (PTSD) among children and adolescents residing in low- and middle-income countries (LMICs) poses a significant public health concern. However, there is variation in the evidence of effective psychological interventions. This meta-analysis aims to provide a complete overview of the current body of evidence in this rapidly evolving field.MethodsWe conducted searches on PubMed, Embase.com, and EBSCO/APA PsycInfo databases up to June 23, 2022, identify randomized controlled trials (RCTs) investigating the effectiveness of psychological interventions in LMICs that targeted children and adolescents with elevated symptoms above a cut-off score for depression, anxiety, and PTSD, comparing a psychological or psychosocial intervention with other control conditions. We conducted random effects meta-analyses for depression, anxiety, and PTSD symptoms. Sensitivity analysis for outliers and high-risk studies, and analyses for the publication bias were carried out. Subgroup analyses investigated how the intervention type, intervention format, the facilitator, study design, and age group of the participant predicted effect sizes.ResultsThirty-one RCTs (6,123 participants) were included. We found a moderate effect of interventions on depression outcomes compared to the control conditions (g = 0.53; 95% CI: 0.06-0.99; NNT = 6.09) with a broad prediction interval (PI) (-1.8 to 2.86). We found a moderate to large effect for interventions on anxiety outcomes (g = 0.88; 95% CI: -0.03 to 1.79; NNT = 3.32) with a broad PI (-3.14 to 4.9). Additionally, a moderate effect was observed on PTSD outcomes (g = 0.54; 95% CI: 0.19-0.9; NNT = 5.86) with a broad PI (-0.64 to 1.72).ConclusionsPsychological and psychosocial interventions aimed at addressing depression, anxiety, and PTSD among children and adolescents in LMICs have demonstrated promising results. However, future studies should consider the variation in evidence and incorporate long-term outcomes to better understand the effectiveness of these interventions

A moderate dose of alcohol selectively reduces empathic accuracy

RATIONALE: Drinking alcohol is associated with various interpersonal effects, including effects on cognitive empathy. Empathic accuracy (EA) is a form of cognitive empathy concerned with perceivers' accuracy in inferring a target's thoughts and feelings. The effects of alcohol on EA have not previously been studied. OBJECTIVES: We examined the effect of a moderate alcohol dose on EA in social drinkers. METHODS: Fifty-four men with varying levels of hazardous drinking according to the Alcohol Use Disorders Identification Test (AUDIT) participated in a randomized, double-blind, between-group study. The alcohol group received 0.56 g/kg alcohol in a vodka and tonic-mixed drink. The placebo group received tonic, with 4 ml of vodka sprayed on top. All participants performed an EA task that involved watching 16 videos of people narrating positive and negative emotional autobiographical events and continuously rating how targets felt while narrating. RESULTS: There were no significant main effects of beverage condition on the EA task. There was an effect of the condition by AUDIT interaction for EA on the positive videos. Post-hoc simple contrasts revealed that in participants with lower AUDIT scores, the alcohol condition had lower EA for positive videos than the placebo condition. No significant main effect for condition occurred in the participants with higher AUDIT scores. CONCLUSIONS: The effect of condition in participants with lower AUDIT scores indicates alcohol selectively reduced EA in individuals low on hazardous drinking. This suggests either alcohol-induced impairments of EA for positive events or a positivity bias in men at low risk for alcohol dependency

Young children’s development after forced displacement: a systematic review

Abstract Objectives To examine the impact of displacement experiences on 0- to 6-year-old children’s social-emotional and cognitive development, as well as influencing factors on reported outcomes. Study design We systematically searched MEDline, Psyndex, Cochrane Library, Web of Science, Elsevier, TandF, Oxford Journal of Refugee Studies, Journal of Immigrant & Refugee Studies, and Canada’s Journal on Refugees for existing literature regarding social-emotional and cognitive outcomes in children directly exposed to forced displacement due to political violence. Results were synthesized in the discussion and displayed using harvest plots. Results Our search generated 9,791 articles of which 32 were selected for review and evaluation according to NICE criteria. Included studies provided results for 6,878 forcibly displaced children. Measured outcomes were diverse and included areas such as peer relations, prosocial behavior, family functioning, play, intelligence, learning performance, and language development. Repeated exposure to adverse experiences, separation from parents, parental distress, as well as duration and quality of resettlement in the host country were reported as influencing factors in the reviewed studies. Conclusion As protective factors like secure and stable living conditions help to promote children’s development, we call for policies that enhance participation in the welcoming society for refugee families. Early integration with low-threshold access to health and educational facilities can help to mitigate the wide-ranging negative consequences of forced displacement on young children’s development